Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China.
Sci Rep. 2020 Dec 18;10(1):22300. doi: 10.1038/s41598-020-78570-1.
Cerebral venous sinus thrombosis (CVST) combined with intracerebral hemorrhage(ICH) is a special subgroup, and whether intrasinus thrombolysis (IST) or mechanical thrombectomy (MT) therapy should be carried out is controversial because of previous hemorrhage and possible delayed hemorrhage.The aim of this study was to analyze the safety and effectiveness of endovascular treatment of CVST with ICH and further discuss the treatment strategy. This is a retrospective study of 56 cases admitted from January 2010 to June 2019 diagnosed with CVST combined with ICH, and all were treated with endovascular treatment including IST with or without MT. We reviewed the clinical, radiological, and outcome data of all patients. The percentage of cases that showed complete and partial recanalization were 67.8% and 26.9% after endovascular treatment. ICH exacerbation occurred in 5 cases during thrombolysis. The percentage of cases with good outcome was 87.5% at discharge. 51 cases were followed up at sixth month. 49 cases had a mRS score of 0-2,and 2 cases had a mRS score of 3-4 at sixth month.Our data suggest that endovascular treatment may improve clinical and radiological outcome in most patients of CVST with ICH, but confirmation in prospective, controlled studies is warranted.
脑静脉窦血栓形成（CVST）合并脑出血（ICH）是一个特殊的亚组，由于先前的出血和可能的延迟性出血，是否进行窦内溶栓（IST）或机械取栓（MT）治疗存在争议。本研究旨在分析伴有脑出血的 CVST 血管内治疗的安全性和有效性，并进一步探讨治疗策略。这是一项回顾性研究，纳入了 2010 年 1 月至 2019 年 6 月期间诊断为 CVST 合并 ICH 的 56 例患者，所有患者均接受血管内治疗，包括 IST 联合或不联合 MT。我们回顾了所有患者的临床、影像学和转归数据。血管内治疗后完全和部分再通的病例比例分别为 67.8%和 26.9%。溶栓过程中 5 例出现 ICH 加重。出院时预后良好的病例比例为 87.5%。51 例在第 6 个月进行了随访。49 例 mRS 评分为 0-2，2 例 mRS 评分为 3-4。我们的数据表明，血管内治疗可能改善大多数伴有脑出血的 CVST 患者的临床和影像学转归，但需要前瞻性、对照研究来证实。
